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 Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 69-71

Erupted and nonerupted compound odontoma in prosthodontic patients: Report of two cases


1 Department of Oral Medicine and Radiology, College of Dentistry, Al Jouf University, Sakaka, Al Jouf, Saudi Arabia
2 Department of Oral Medicine and Radiology, Jodhpur Dental College and General Hospital, Jodhpur, Rajasthan, India
3 Department of Prosthodontics, College of Dentistry, Al Jouf University, Sakaka, Al Jouf, Saudi Arabia
4 Department of Oral Pathology, College of Dentistry, Al Jouf University, Sakaka, Al Jouf, Saudi Arabia
5 Department of Pedodontics, College of Dentistry, Al Jouf University, Sakaka, Al Jouf, Saudi Arabia

Date of Web Publication16-Jun-2016

Correspondence Address:
Santosh R Patil
Department of Oral Medicine and Radiology, College of Dentistry, Al Jouf University, Sakaka, Al Jouf
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.184216

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  Abstract 

The odontomas constitute most common benign odontogenic tumors of the jaws. Majority of odontomas are nonsymptomatic and are detected on routine radiographic examination. They represent up to 22% of all odontogenic tumors of the jaws. This lesion is composed of more than one type of odontogenic tissues and for this reason, it is also known a composite odontoma. In a 32-year-old male, well-defined small teeth like structure were noticed distal to maxillary second molars bilaterally which were confirmed radiologically and histopathologically as eruption odontome. In the second case, multiple miniature tooth-like structures of varying densities were observed pericoronally to the impacted canine on the X-ray, which was confirmed as compound histologically.

Keywords: Erupted, hamartoma, odontoma


How to cite this article:
Patil SR, Yadav N, Mousa MA, Rao KA, Gudipaneni RK. Erupted and nonerupted compound odontoma in prosthodontic patients: Report of two cases. J Dent Res Rev 2016;3:69-71

How to cite this URL:
Patil SR, Yadav N, Mousa MA, Rao KA, Gudipaneni RK. Erupted and nonerupted compound odontoma in prosthodontic patients: Report of two cases. J Dent Res Rev [serial online] 2016 [cited 2022 Nov 27];3:69-71. Available from: https://www.jdrr.org/text.asp?2016/3/2/69/184216


  Introduction Top


Odontomas are hamartomatous malformations which are usually asymptomatic and diagnosed on routine radiological examination.[1] Broca coined the term odontome and defined it as a tumor formed by an overgrowth of complete dental tissue. Odontomas are made up of enamel, dentin, cementum, and occasionally pulp tissue.[2] As per 2005 WHO classification of odontogenic tumors, odontomes are of two types, compound odontomas, and complex odontomas. The compound odontomas constitute of two or more tooth-like structures with enamel-capped crowns known as denticles.[3] Whereas in complex odontomas there no morpho-differentiation is present and tit usually appears as a single complex mass with the unorganized distribution of enamel, dentine, and cementum. Odontomas have also been classified as central odontoma when they are located inside the bone and peripheral odontoma when they present in the soft tissue and having a tendency to exfoliate.[4] Two cases of compound odontomas in prosthodontic patients are reported here.


  Case Reports Top


Case 1

A 32-year-old male patient reported for the replacement of missing teeth in his upper and lowered jaw. Patient has undergone extraction of these teeth few months back as they were badly carious and painful. Patient's family history and medical history was not significant. Intraoral examination revealed missing maxillary left and mandibular right first permanent molars. Well-defined small teeth like structure were noticed distal to maxillary second molars bilaterally. A panoramic radiograph was made which revealed these structures to be located at pericoronal region of maxillary second molars on both sides [Figure 1]. Clinical and radiographic features of these structures were suggestive of erupting compound odontome. These structures were extracted under local anesthesia. The extracted specimens were subjected to histopathological examination, which revealed enamel, dentin, and cementum with pulp space which confirmed the diagnosis [Figure 2]. The patient was planned for placement of implants and replacement of missing teeth.
Figure 1: Panoramic radiograph showing erupting compound odontoma bilaterally

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Figure 2: Ground section showing organised tooth like structures (×40)

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Case 2

An 18-year-old female reported with a chief complaint of missing teeth in the front region of upper jaw. Patient informed that permanent teeth in that region did not erupt after exfoliation of deciduous teeth, few years back. The patient did not give any significant family history or medical history. Intraoral examination revealed missing permanent maxillary right canine. Maxillary occlusal radiograph was done for the patient which showed impacted maxillary canine [Figure 3]. Along with this multiple miniature tooth-like structures of varying densities were present pericoronally to the impacted canine. These were diagnosed as erupting compound odontome. These structures were surgically removed along with the impacted canine under local anesthesia. The extracted specimens were subjected to histopathological examination, which confirmed the diagnosis of compound odontoma [Figure 4]. Fixed prosthesis was later planned for the patient.
Figure 3: Occlusal radiograph multiple tooth like structures

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Figure 4: Photomicrograph of ground section showing enamel rods and dentinal tubules (×200)

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  Discussion Top


Odontomas are known to be the common odontogenic tumors of the jaws which are nonmalignant, slow growing, and nonaggressive. The exact etiology of odontomas is not clear till date; literature review suggests that different factors such as infection, local trauma, growth pressure, odontoblastic hyperactivity, hereditary anomalies, the persistence of a portion of a dental lamina and developmental influences may be implicated.[5] The complex odontomas are usually encountered in the posterior mandible while composite odontomas are more located in the anterior region of the maxilla.[6] Odontomas are usually asymptomatic and are detected on routine radiographic examination. There are few cases which were are reported with swelling, delayed eruption, and in severe cases infection or lymphadenopathy was also noted. Pathologies such as devitalization, malformation, aplasia, malposition, and impacted teeth.[7] In accordance to this, impaction of maxillary canine was noted in the case 2 reported here, but case 1 was not reported with any symptoms associated with odontoma. Compound odontoma is usually encountered between the apex of deciduous tooth and the crown of the permanent tooth preventing the eruption of latter.[8] However, in both the cases reported here, the odontomas were located pericoronally to the permanent teeth. The characteristic radiographic features of the odontomas always helpful in diagnosing this condition. Compound odontomas are seen as multiple teeth like structures of varying size and shape are seen, which are termed as denticles.[9] An unusual case of compound odontome associated with numerous pulp calcification has been reported in the literature. This condition is managed by conservative surgical excision with fewer chances of recurrences.[10]


  Conclusion Top


Two cases of compound odontomas in partially edentulous patients are reported here. Since odontomas constitute a large proportion of benign jaw tumors, adequate knowledge of their characteristics is necessary for the establishment of their proper diagnosis and timely management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Frame JW. Surgical excision of a large complex composite odontome of the mandible. Br J Oral Maxillofac Surg 1986;24:47-51.  Back to cited text no. 1
    
2.
Cohen DM, Bhattacharyya I. Ameloblastic fibroma, ameloblastic fibro-odontoma, and odontoma. Oral Maxillofac Surg Clin North Am 2004;16:375-84.  Back to cited text no. 2
    
3.
Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization Classification of Tumours. Pathology and Genetics of E558 Head and Neck Tumours. Lyon: IARC Press; 2005. p. 310.  Back to cited text no. 3
    
4.
Laskin DM. Surgical management of a large, complex mandibular odontoma by unilateral sagittal split. J Oral Maxillofac Surg 1989;47:183-4.  Back to cited text no. 4
    
5.
Shekar SE, Roopa SR, Gunasheela B, Supriya N. Erupted compound odontoma. J oral Maxillofac Pathol 2009;13:47-50.  Back to cited text no. 5
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6.
Reichart PA, Philipsen HP. Complex odontoma. In Odontogenic Tumours and Allied Lesions. Chicago: Quintessence Pub. Co. Ltd.; 2004. p. 141-9.  Back to cited text no. 6
    
7.
Vengal M, Arora H, Ghosh S, Pai KM. Large erupting complex odontoma: A case report. J Can Dent Assoc 2007;73:169-73.  Back to cited text no. 7
    
8.
Ajike SO, Adekeye EO. Multiple odontomas in the facial bones. A case report. Int J Oral Maxillofac Surg 2000;29:443-4.  Back to cited text no. 8
    
9.
Serra-Serra G, Berini-Aytés L, Gay-Escoda C. Erupted odontomas: A report of three cases and review of the literature. Med Oral Patol Oral Cir Bucal 2009;14:E299-303.  Back to cited text no. 9
    
10.
Sarode GS. Sarode CS, Anand R, Waknis P. The pulp stone in compound odontome: An unusual finding. World J Dent 2015;6:241-2.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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